A simple risk score in acute ST-elevation myocardial infarction: Modified ACEF(age, creatinine, and ejection
Arzu Kalaycı1, Vecih Oduncu1, Çetin Geçmen1
1Department of Cardiology, Koşuyolu Heart Education and Research Hospital, İstanbul, Turkey.
Insights
The modified ACEF score predicts cardiac mortality and major adverse events in ST-elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PCI). This scoring system aids in risk stratification for better patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Risk Stratification
Background:
- ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring timely intervention.
- Primary percutaneous coronary intervention (PCI) is the standard treatment for STEMI.
- Accurate risk prediction is essential for managing STEMI patients post-PCI.
Purpose of the Study:
- To evaluate the modified ACEF (age, creatinine, ejection fraction) score's predictive value for major adverse cardiac and cerebrovascular events (MACCE).
- To assess the score's utility in patients with STEMI undergoing primary PCI.
- To determine the score's association with 1-year mortality and morbidity.
Main Methods:
- Retrospective analysis of 1632 STEMI patients treated with primary PCI.
- Calculation of the modified ACEF score for each patient.
- Grouping patients into tertiles based on the modified ACEF score for comparative analysis.
Main Results:
- Higher modified ACEF scores were associated with increased rates of out-of-hospital cardiac arrest, Killip class ≥ II, and cardiogenic shock.
- Lower ejection fraction was observed in patients with higher modified ACEF scores.
- Significant differences in 1-year cardiac mortality, target vessel revascularization, stroke, reinfarction, and MACCE were found across score tertiles.
Conclusions:
- The modified ACEF score is a significant predictor of cardiac mortality and morbidity.
- The score effectively stratifies risk in STEMI patients undergoing primary PCI.
- The modified ACEF score can aid clinicians in identifying high-risk patients for closer monitoring and tailored management.
Background/Aim:
The aim of this study was to evaluate if the modified ACEF (age, creatinine, and ejection fraction) score is a predictor of major adverse cardiac and cerebrovascular events during 1 year of follow-up in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).
Materials And Methods:
We retrospectively enrolled 1632 consecutive patients who were admitted to our emergency department diagnosed with STEMI within 12 h of chest pain and treated with primary PCI. The modified ACEF score, determined with a simplified scoring system, was calculated. The patients were grouped into tertiles according to this score (group I mACEF < 1.03, group II mACEF 1.03-1.37, group III > 1.37) . The clinical and angiographic data were compared among the tertiles.
Results:
In patients with the highest mACEF tertile, out-of-hospital cardiac arrest (1.3%, 1.8%, and 4.1% consecutively; P = 0.003), Killip class ≥ II (P < 0.001), and cardiogenic shock were more common and ejection fraction was lower (P < 0.001). Moreover, in the 1-year follow-up, there was a statistically significant difference between cardiac mortality, target vessel revascularization, stroke, reinfarction, and major adverse cardiac and cerebrovascular events of the groups, while the rates of stent thrombosis were similar.
Conclusion:
The modified ACEF score is a predictor of cardiac mortality and morbidity during 1-year follow-up.
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